The Cardiology Training Program at the University of Alberta accepts as its overall goals the objectives for subspecialty training in cardiology put forth by the Royal College of Physicians and Surgeons of Canada and the Bethesda Task Force in Adult Cardiology Training of the American College of Cardiology. The general principles important in general internal medicine training are also applicable to cardiology. However, major advances in the diagnosis and treatment of patients with cardiovascular diseases have increased the demands on the cardiovascular specialist and require ongoing re-evaluation of cardiovascular training.
The Cardiology Training Program is blessed with the Mazankowski Alberta Heart Institute, an outstanding physical plant and diagnostic facility. Within this setting, the Division is able to provide an intellectual environment in which the knowledge, clinical skill, judgment, compassion and attitudes essential to the modern cardiologist can be developed. The Division maintains close working relationships with cardiovascular surgery as well as with the Department of Medicine and the other subspecialty divisions within it. Well-defined levels of responsibility by trainees and staff are necessary, with the trainee assuming greater responsibility as training progresses. Trainees are held in high esteem by the clinical care team and the collegial working environment allows them to operate as junior faculty. The trainee is also encouraged to cultivate an attitude of scholarship and dedication to continuing education that will remain throughout his or her professional career.
The Division believes that the following overall objectives must be met at the conclusion of the program:
- All trainees must be adept at obtaining a history and performing a complete cardiovascular physical examination. They must be familiar with psychological factors and their impact on cardiovascular diseases and must be familiar with the importance of preventive and rehabilitative management in cardiovascular medicine.
- The trainee must become well educated in pathogenesis, pathology, epidemiology, natural history, diagnosis and management of cardiovascular disease including coronary atherosclerosis, valvular disease, cardiomyopathy, congenital heart disease, arrhythmias, hypertension, pericardial disease, infective endocarditis, pulmonary heart disease, cardiac trauma, cardiac tumors and cardiac complications of systemic disease.
- The trainee must be adept in the management of patients requiring cardiovascular intensive care and must be an expert in the techniques of advanced cardiac life support.
- The trainee must be well versed in outpatient management of the cardiac patient, with expertise in all age groups from adolescence to old age.
- The trainee must be an expert in 12-lead electrocardiographic interpretation and skilled in interpretation of exercise and ambulatory electrocardiograms.
- The trainee must have experience in right and left heart catheterizations, with this experience emphasizing interpretation of pressure recordings, analysis of hemodynamics, angiographic interpretation, and understanding of indications for coronary angioplasty and valvuloplasty.
- The trainee must have experience in performance and interpretation of M-mode, two-dimensional and Doppler echocardiograms.
- The trainee must know the general principles, indications for and limitations of nuclear cardiovascular investigations and must understand the principles of radiation safety. The trainee must have experience supervising and interpreting these examinations.
- The trainees must be knowledgeable of the indications for permanent cardiac pacing and the long-term management of the pacemaker patient.
- The trainee must understand the indications for and principles of invasive electrophysiologic testing.
- The trainee must complete a minimum of one research project. This must include the development of a hypothesis and a means to answer that question, the implementation of the project, the analysis of results, and the formulation of these results into a form suitable for submission to a scientific forum for presentation.
- The trainee must attend and participate in regular cardiology conferences, seminars, journal review activities, multidisciplinary conferences, and lectures by visiting professors and research seminars.
- The trainee must participate in medical education through presentation of rounds and seminars, teaching during ward rounds, and supervision of junior residents and medical students.
- The trainee must undergo biannual evaluation, which will be based on his/her meeting the overall objectives for the program as well as the specific objectives for each rotation. Evaluations will also evaluate intellectual abilities, technical skills, interpersonal skills, judgment, and clinical acumen, as well as a more formal assessment through a biannual RCPSC style examination.
Towards these ends, our program is organized to allow each trainee to meet these objectives to the best of his or her ability. Trainees wishing to become an expert in any particular technical skill will require additional supervised training in that area following the guidelines of the Canadian Cardiovascular Society. The core program is strongly based in clinical cardiology, and is designed to expose the trainee to a broad range of acute and chronic cardiovascular diseases. We emphasize accurate bedside diagnosis, appropriate use of diagnostic tests, and application of general cardiologic principles to each individual case with an appreciation of the uniqueness of each patient. We provide exposure to nearly all methods of invasive and noninvasive testing in cardiology. Finally, we require participation in research by trainees as a means to develop critical thinking and an inquisitive attitude toward current problems in cardiovascular disease.